刘 雪,马 磊,马晓栋,吕荣华

慢性肾脏病（chronic renal failure，CKD）是由多种病因所致的肾脏结构异常，患病率呈逐年递增趋势，已成为全球性的公共卫生问题。描述心脏和肾脏之间相互作用的综合征是公认的，但从未被明确定义和分类。超过60%的急性失代偿性心力衰竭入院患者患有CKD，定义为eGFR为<60 ml/min/1.73 m2。CKD是急性失代偿性心力衰竭中死亡和心血管事件的最强危险因素之一。心肾综合征(CRS)分为5种亚型，其中4型CRS最为常见，4型CRS指慢性肾脏功能不全导致慢性心脏结构和(或)功能的损害，目前对CRS尚无有效的诊断和治疗方法。本文就CRS-4的流行病学、病理生理、诊断及治疗方面进行综述，重点是描述病理生理及相关生物标志物的研究进展及临床意义。

心肾综合征；流行病学；病理生理；生物标记物；诊疗进展

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